97026 cpt code

97026 CPT Code (2022) – Description & Billing Guidelines

Infrared therapy can be billed with CPT code 97026. The description of CPT 97026 and the billing guidelines can be found below.

97026 CPT Code Description

Description Of CPT 97026: CPT code 97026 can be billed for the application of an infrared modality to one or more areas. The official description of this code can be found below.

Description Of CPT Code 97026
Description Of CPT Code 97026

Billing Guidelines For CPT Code 97026

The Centers for Medicare and Medicaid Services announce a NCS stating the use of infrared and/or near-infrared light and/or heat, including monochromatic infrared energy, is non-covered for the treatment, including symptoms such as pain arising from these conditions, of diabetic and/or non-diabetic peripheral sensory neuropathy, wounds and/or ulcers of the skin and/or subcutaneous tissues in Medicare beneficiaries.

Further coverage guidelines can be found in the National Coverage Determination (Pub. 100-03), Section 270.6.


Medical Necessity Of CPT Code 97026

Infrared application applied in the absence of associated procedures or modalities, or used alone to reduce discomfort, are considered not medically necessary and therefore, are not covered.

The application of infrared therapy is considered medically necessary for patients requiring the application of superficial heat in conjunction with other procedures or modalities, to reduce or decrease pain/produce analgesia, reduce stiffness/tension, myalgia, spasm, or swelling.

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